10 Expert Tips for Cleaning Out Your Medicine Cabinet

Should your pills stay or should they go? Going by the expiration date is unsatisfying; many people suspect their meds are perfectly usable months after they've supposedly expired. And they're right: A 1980s study conducted by the FDA and the military revealed that most pills remain effective years after their expiration date. But how can you be sure? We talked to doctors, pharmacists and the FDA to get these 10 tips for gauging a date's accuracy—and more.

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1. What to Save, What to Toss

"In general, I would say many oral medications are safe to take a year or two beyond their marked expiration date," says Sara Bingel, PharmD, clinical pharmacist at New York City's Mount Sinai Hospital.

2. Heed Expiration Dates on Lifesaving Drugs

The FDA requires manufacturers to determine how long it takes a drug to reach a potency level of 95%; when it's reached that level, it's "expired." The point: Expiration dates are about efficacy, not safety. "How important is it that you need to get the right amount into your body?" says Michael J. Negrete, PharmD, CEO of the Pharmacy Foundation of California. "I might be willing to roll the dice with cough syrup. It's no big deal if the potency is down and it doesn't help my cough. But imagine an EpiPen, which keeps people from going into anaphylactic shock, not working."

3. Realize There's No Magic Formula

"Let's say it takes a year for a drug's potency to decrease to 95%," says Paul Langevin, MD, director of cardiac anesthesiology at Waterbury Hospital in Waterbury, Connecticut. "I can't tell you six months later if it's at 93% potency or at 33%. That data's not available." It's not available because drug companies don't want to spend money for the tests. The point? If you're uncomfortable with guesswork, go by the marked date.

4. Keep the Solids, Toss the Liquids

Gel capsules, liquids and suspensions (in which the active ingredient is "suspended" in liquid) lose potency more quickly than pills and capsules—and, worse, they're at risk of becoming contaminated by bacteria. "Think rancid milk," says Bingel. The upshot? Pay attention to the expiration dates on liquid medications.

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5. Save Meds by Storing Them Well

Expiration dates are based on the assumption that an unopened package is stored in a cool, dry, dark place. That's why it's smart to take storage conditions into account when deciding whether to keep a medication: An unopened package of Benadryl kept in a dark drawer in a dry Southwestern city will likely work for years after the expiration date. In contrast, medicine cabinets—often placed in humid bathrooms—tend to be terrible places for medications. Ditto with hot, sunlit cars.

6. Get Rid of Expired Antibiotics

"I would advise patients never to take antibiotics that are expired," says Bingel. "They may not completely kill the bacteria and lead to a resistant infection." Even worse, tetracycline—a common antibiotic—is one of the few medications ever shown to be toxic (not just less potent) after its expiration date.

7. Know Where the Meds Originated

Pharmacies take pills out of their original containers, repackage them and put new expiration dates on. It's hard to be definitive, but a medication dispensed by a pharmacy is likely to lose its potency faster than a medication that remains in an unopened container—even if the pharmacy's container isn't opened. Think of it as another factor to consider when doing your educated guesswork about what to keep and what to toss.

8. Look for Visual Clues

If a pill crumbles in your hand, it's probably best not to take it. But there are subtler clues, too, like smell: Too-old aspirin, for example, smells like vinegar. "Be suspicious of anything that looks out of the ordinary," says Negrete. Faded dyes or funny smells may not actually mean the drug is less potent, but they're clues that something's decomposing—a good reason to get a new bottle.

9. Don't Keep Kids' Meds

"Because children are smaller and their metabolic systems aren't fully developed, I wouldn't hang on to kids' meds past the expiration dates," says Dr. Langevin. "Plus, a lot of medications for children are prepared in suspensions so the kids will take them, and those flavored liquids can decompose and acquire bacterial growth."

10. Go Through Your Medicine Cabinet Once a Year

The American Medical Association recommends cleaning out your medicine cabinet once a year. It may be tempting, if you're the organized type, to decant frequently used drugs into labeled, matching bottles, but don't—keeping pills in their original containers guards against confusion and is thus safer, says Negrete. However, do take those cotton balls out of bottles; they hasten decomposition.

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